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Hashimoto’s Encephalopathy Presenting as Acute Psychosis

Abstract

Rameshwar Nath Chaurasia and Vijay Mishra

Background: Hashimoto’s encephalopathy is a relapsing encephalopathy occurring in association with Hashimoto’s thyroiditis, with high titers of anti-thyroid antibodies. Clinically the patients may presents with acute or subacute encephalopathy, seizure, myoclonus, and tremulousness, stroke like episode, amnesia or dementia. Here we are reporting a case of hashimoto’s encephalopathy who presented with features of acute psychosis. Case Report: A 56 years old Asian female presented with acute onset of altered behavioural abnormality and declining brain function. Serology revealed high anti thyroperoxidase antibodies. EEG and MRI were consistent with hashimoto’s encephalopathy. Conclusion: Hashimoto’s encephalopathy is a rare complication of hashimoto’s thyroiditis and is a diagnosis of exclusion and should be suspected in a case of encephalopathy, high anti thyroid antibodies and response to glucocorticoid.

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